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December 2011, Volume 41 Number 12 , p 45 - 49


  • Janine Jagger PhD, MPH
  • Jane Perry MA
  • Ginger Parker MBA
  • Elayne Kornblatt Phillips PhD, MPH, RN


LAST SPRING, Nursing2011 invited nurses to participate in a survey exploring blood exposure risks from peripheral I.V. catheter insertion and removal. Although needlestick risk from I.V. catheter devices has been well documented in device studies carried out in the 1990s and early 2000s,1-3 blood exposures sustained by healthcare workers during peripheral I.V. catheter insertion or removal have received less attention.In data from the CDC on occupationally acquired HIV in healthcare workers, I.V. insertion was second only to phlebotomy among procedures causing injuries resulting in infections-despite the fact that I.V. catheter needles represent only a small fraction of sharps used in healthcare delivery.4Blood exposures to nonintact skin and mucous membranes, while not carrying the same risk as sharps injuries, have nevertheless been the documented source of bloodborne pathogen transmission, although not specifically linked to I.V. catheter insertion or removal.5,6 In the 2001 recommendations for follow-up of occupational exposures, the CDC defined at-risk blood exposures as "contact of mucous membrane or nonintact skin (e.g., exposed skin that is chapped, abraded, or afflicted with dermatitis) with blood, tissue, or other body fluids that are potentially infectious." For skin exposures, "follow-up is indicated only if there is evidence of compromised skin integrity."7Of nurses responding to this survey (N = 404), 379 indicated that they performed peripheral I.V. catheter insertions, removals, or both (those who indicated they performed neither insertions nor removals were removed from the database). They provided details on the frequency and mechanisms of blood exposures associated with I.V. catheters. For a profile of respondents to this survey, see Take a closer look at respondents.As you review the results summarized here, keep in mind that survey participants were self-selected and not necessarily representative of all nurses. For example, nurses who recently

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